Posted on 08/25/2024 9:07:12 AM PDT by ConservativeMind
For years, the treatment of early-stage prostate cancers that haven't spread beyond the organ has often included the removal of nearby lymph nodes in the pelvis. It's done as a precaution and as a means of "staging" the disease.
Now, a major expert review on the topic suggests that, in many cases, men in this situation may be better off keeping their lymph nodes.
Doing so may help them avoid harmful side effects, such as disabling lymphedema.
But even more importantly, leaving the pelvic nodes intact might also boost the success of newer immune-based cancer drugs, the experts suspect.
One study found that, between 2004 and 2013, surgeons removed pelvic lymph nodes in 63.5% of such cases.
Lymph node removal is often used to help determine what stage of prostate cancer a man has.
However, according to one major study, only a small minority of these excised lymph nodes—just 3.7%—ended up containing any cancerous cells.
Removal of lymph nodes for early-stage tumors also has dubious value as a treatment, Tewari's group said.
In studies where patients either did or did not have their nodes removed (along with their prostates), "no statistically significant differences" in terms of tumor recurrence, tumor spread or overall survival were found, the experts noted.
Then there's the potential help that intact lymph nodes might provide to men treated with newer, immune-focused cancer therapies called immune checkpoint inhibitors.
Immune checkpoint inhibitors include Keytruda, Opdivo, Yervoy and Tecentriq.
As Tewari explained, there's a growing body of evidence that pelvic lymph nodes near the prostate tumor (so-called "tumor-draining lymph nodes") contain cells that help immune checkpoint inhibitors do their work.
From early studies, however, "it seems that lymph nodes have a vital role in the mobilization" of immune cells that have been targeted to fight tumors, the team said.
(Excerpt) Read more at medicalxpress.com ...
I heard on the radio yesterday that the doctor who created the prostate test is livid, since the test was never meant to diagnose potential cases — it was focused on existing cases.
Kind of like how the inventor of the COVID test felt that it should not be used for screening purposes.
Here’s what ChatGTP says:
Yes, Dr. Richard J. Ablin, who discovered the prostate-specific antigen (PSA) in 1970, has expressed concerns about the widespread use of the PSA test for prostate cancer screening. He believes that the test is not a reliable indicator of prostate cancer and can lead to overdiagnosis and overtreatment. Dr. Ablin has argued that the PSA test should not be used as a routine screening tool for prostate cancer.
What procedure 100% gaurantees no cancer?
Only procedure I care about.
On the other hand
(anecdotal) I had a PSA test. Popped a 12. Biopsy showed early-stage cancer. The biopsy gave me a 4+3 Gleeson score.
PET scan showed the cancer in a small part of the prostrate.
Had radiation treatment.
I’ll be alive to see my grandkids at least go to school.
Don’t use ChatGPT+BS, do your own homework using source documents.
Regardless of what Dr. Ablin says, the PSA is an effective tool for diagnosis. Just like A1C is an indication of diabetes. Not an absolute, rather it gives doctor’s an indication. I know from my own personal experience because in Jan 2023, I was diagnosed with prostate cancer. The ONLY reason we looked further was because of an elevated PSA result. I had NO other symptoms. And it wasn’t just a matter of a little bit of cancer that other men in their mid-60’s have, rather the pathology results after my prostatectomy showed that the cancer was aggressive, Stage 3.
I agree!! I had a similar experience. AND my initial PSA when it was finally checked was 12.5. My VA primary care provider argued with me that that could “mean anything”. I insisted, so he ordered another test three months later and it was 14. The week before my prostatectomy, PSA was 17.5. Pathology results also showed Extraprostectic Extension, which means cancer was in the margins of the prostate. If I had listened to my first doctor, the cancer would have metastasized.
My prostate cancer was detected early and only a 7 Gleason score. Nobody ever suggested lymph node removal.
With regard to specific recommendations in the elderly population, general consensus exists against routine screening in men with a life expectancy of less than 10 to 15 years because the expected mortality benefit from screening is estimated to occur years after the initial screening
bump
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